Low-Dose Radiation Therapy for Foot and Ankle Osteoarthritis

Foot and ankle osteoarthritis includes involvement of the talocrural joint, subtalar joint, midfoot, and MTP joints. Low-dose radiation therapy (LDRT) is an established option for this indication in European practice.

Evidence

• Weissmann et al.: 196 patients; 84% showed clinically meaningful pain response at 3 months — the highest joint-specific response rate reported in the LDRT literature.
• Hautmann et al.: 66 patients; median pain score 7 before treatment, 4 at 12-month follow-up. No significant difference between primary and post-traumatic OA (low-level retrospective finding).

The 2026 ARS Appropriate Use Criteria identifies foot and ankle OA as an appropriate indication after prior treatment failure. Distal joints involve minimal bone marrow irradiation and limited radiosensitive organ proximity.

Typical dosing: 3 Gy total in 6 fractions of 0.5 Gy each, 2–3 sessions per week. See candidacy criteria and find a provider.

Medically reviewed by: Robert Warren Floyd, M.D., Ph.D. — Resident Physician, Radiation Oncology, The University of Texas MD Anderson Cancer Center. Last reviewed: August 2, 2026. Independent personal project — not affiliated with or endorsed by MD Anderson Cancer Center. Funding & independence disclosure.